Does Self-Medication Equal Self Destruction?

We take a look at the balance between self-help and self-harm and ask the question – When does the substance become the presence in one’s life?

By John Madden

Let’s be frank, substance abuse is widespread) and there does not seem to be any end in sight. We turn on the news, flick through the papers and see the articles pop up on our Facebook pages every other day. It’s a never ending cycle, but for every haul that’s retrieved by the authorities, there’s probably three more shipments getting through. Whatever the approach to prevention, it’s just not working. In recent times we’ve seen the rise and fall of the Head-Shop, escalated incidences of “home-grown” and almost industrialised operations of cannabis herb cultivation. Along with the notion of “recreational use” there is an increased incidence of people using these substances to mask underlying health problems, both physical and mental. As a result, some people try to alleviate their symptoms by self-medicating, for the simple reason that it may seem like an easier route as it can help avoid the cost and perceived hassle of visiting the doctor, as well as not having to deal with the underlying problems.

Self-medication refers to the practice of using prescriptions or over-the-counter medicines without discussing your symptoms with your own GP or any medical professional. Essentially the person acts as their own doctor in an effort to manage their mental health concern. The reasons why anybody may decide to self-medicate can depend on their personal circumstances. It can often be an effort to hide their current condition in plain sight or they may be using a substance to hide their condition from others. It may also be an attempt to fix the issue without the expense of seeing a GP or as a direct result of personal fears associated with a medical diagnosis.
Other people experiencing mental health issues sometimes try to “fix” their illness by using certain drugs. Those suffering from depression or anxiety may find a quick and sometimes immediate relief when using alcohol or cannabis but ultimately this causes more harm than good, worsens the symptoms and can even lead to dependence or addiction along with the other side effects of abusing such substances.
While alcohol and cannabis abuse is more prevalent there is an increased use of cocaine and amphetamines. These are classed as psychostimulants as they can cause short term euphoria in the users, but as with the others, the relief from the symptoms of illness are short lived. Cocaine can lead to addiction and heighten depression in the long-term as well as causing major damage to the body’s cardiovascular system which can commonly result in sudden heart failure; Amphetamines speed up the function and increases the risk of having a stroke.

Cocaine is considered a life-risking drug. It can be fatal when used as a recreational drug. Cocaine does major damage to the body’s cardiovascular system. Common cocaine-related deaths occur as a result of sudden heart failure.
While using these substances might give a narrow distraction from mental health issues, they only serve to exacerbate the problems facing the user for the simple fact that, “what goes up, must come down”… and sometimes further down than where they were before using it.
Another means of self-medicating which is becoming more visible across Ireland is the illicit trade in prescription drugs. To many, it might be seen as a low risk because these products are semi-legal, however, the effects of their abuse on addicts is at the same level of severity as many of the previously mentioned substances. Zimmos are the drug of choice for many of the users at the moment, that of course, is the street name for Zopiclone and its effects put the user in a trance-like state, which, like the others, subdue the effects and symptoms of depression for a short period. This is a growing trend and a topic that requires a lot more spotlight before it escalates. We spoke with two members of staff from a Dublin-based organisation call HOPE (Hands-On Peer Education). This organisation works in the area of addiction and has seen an increase of epidemic proportions in people presenting with newly acquired tablet addiction. Between them, Irene Crawley and Joe Dowling have amassed decades of experience working at the coalface of these issues. They informed Travellers’ Voice that “most of the drugs that people are using are depressants and while using them they experience a lot of memory loss, disorientation and then when they are coming off them they are experiencing anxiety, panic attacks and if they have been taking huge amounts they can then have withdrawals which can result in seizures which would have a serious effect on them physically as well as mentally”. We queried the reasons why people turn towards these substances, Joe says, “It’s a mixed bag, a lot that use them have mental health difficulties. To see them walking around you wouldn’t think there was anything wrong with them but then when you talk to them that’s when the mental health issues come out”. Irene then explained “Say you’re somebody who is out of work, you’re hanging out on the street all day, it’s readily available, people are bored and it’s something to do. I’ve asked people why they want to be “out of their heads” or “asleep all day” and they say that there is nothing else to do, they are tired due to the boredom, feel hopeless and that it passes the day”.
In addition, there is a new epidemic of these tablets hitting the streets, and, according to Joe, “it’s a cheaper fix than heroin, cocaine and cannabis… an individual can get a batch of these tablets for between €15 and €20 from a dealer or even get them off the internet”. Simply put it’s the ease of access to attaining them that’s the problem and until the Government passes some effective legislation to combat this it will only escalate and become a greater problem than it already is.
Irene explains; “The people that are using the tablets aren’t new drug users, they often are already involved in addiction, and a lot of them would be using methadone. People stay on methadone long term, this is called stabilisation. The problem is that most of the people that HOPE see are not stable and would be dabbling with other such drugs”.

So what’s being done to prevent this from developing into a full-blown crisis? According to Irene, “there’s no service that caters for people with mental health and addiction issues combined… There are services where people can go into residential accommodation if they have mental health issues and there are treatment centres that will take people with addiction issues, there are no specific places for somebody experiencing both. There’s a lack of safe accommodation, there’s no treatment or rehabilitation facility. A lot of centres won’t take somebody if they have issues other than addiction”. Adding to this Joe explains, “There’s services out there where you can get people on methadone, but the problem with the tablets is that the likes of Hyde Park and such places cannot manage with the demand as they do not have the facilities to do that. People have to detox off tablets in the likes of Beaumont (hospital) but then Beaumont has only 12 or so beds so people end up waiting for months and months and by the time they get in they’ve been destroyed with abuse of the tablets”.
While it is a concern that abuse of these tablets is becoming more and more common, it is still of some comfort to know that organisations such as HOPE are there to help those who need it most. There are other supports out there and if you or a loved one have concerns around this topic, we at Travellers’ Voice would implore you to find out about the supports available locally. Your own GP can help as well as several other organisations; just Google addiction supports in Ireland and you will be presented with a wide range of services. Like so many things, the help is often there, it’s just a case of knowing where to go and how to go about accessing it.

In the meantime, for more information, log onto www.drugs.ie, www.hse.ie, www.citizensinformation.ie